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Three-Day Topotecan Schedule in Heavily Pretreated Recurrent Ovarian Cancer Patients
  1. Marco Calcagno, MD*,
  2. Filippo Bellati, MD*,
  3. Innocenza Palaia, MD*,
  4. Francesco Plotti, MD*,
  5. Stefano Basile, MD*,
  6. Maria Pastore, MD*,
  7. Milena Sansone, MD*,
  8. Cristiana Arrivi, MD*,
  9. Roberto Angioli, MD and
  10. Pierluigi Benedetti Panici, MD*
  1. * Department of Obstetrics and Gynecology, University "La Sapienza," and
  2. "Campus Bio-Medico," Rome, Italy.
  1. Address correspondence and reprint requests to Pierluigi Benedetti Panici, MD, Department of Gynecology, Obstetrics and Perinatology, University of Rome "La Sapienza," Viale del Policlinico, 155-00161 Rome, Italy. E-mail: pierluigi.benedettipanici{at}


Objective: To evaluate the clinical benefit of a 3-day topotecan schedule in heavily pretreated recurrent ovarian cancer patients scheduled for palliative treatment.

Methods: Eligibility criteria were 2 or more prior chemotherapy regimens, Eastern Cooperative Oncology Group performance status of 2 or less; adequate organ function, assessable disease by serum CA-125 measurement before each cycle; and 1 or more cycle of topotecan (1.5 mg/m2 per day) on 3 consecutive days of a 28-day treatment cycle. Toxicity was graded according to the National Cancer Institute Common Toxicity Criteria version 3. Tumor response, stable disease, and progression were evaluated on the basis of CA-125 levels.

Results: A total of 68 patients were considered eligible for the study. Median age was 58 years (range, 40-77 years), and the median number of prior chemotherapy regimens was 2 (range, 2-6). A total of 272 cycles of topotecan were administered, with a median of 4 cycles per patient (range, 1-8). No treatment delays or dose reduction was recorded. Major toxicities were grade 3/4 (18%) neutropenia, neutropenic fever (6%), grade 4 thrombocytopenia (3%), requirements for blood (5%), and platelet transfusions (3%). Thirty-five (54%) of the 64 evaluable patients showed a clinical benefit. Of these, 11 patients (17%) had a partial response, and 24 (37%) had stable disease with a median time to progression of 7.5 months (range, 6-10 months) and 4 months (range, 2-6 months), respectively.

Conclusion: More than half of heavily pretreated ovarian cancer patients may benefit from 3-day topotecan.

  • Recurrent ovarian cancer
  • Salvage chemotherapy
  • Topotecan
  • 3-day schedule

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